ED Coding and Reimbursement Alert

Documentation detailing these injection encounters can fortify claim. Counting the right items, knowing insurer-allowed diagnoses, and documenting affected muscles will get your trigger point injection (TPI) claims paid while protecting you from paybacks. Check out these coding do's and don'ts to optimize your TPI coding: Do Count Muscles Injected Coders should report 20552 (Injection[s]; single or multiple trigger point[s], 1 or 2 muscles) when the physician injects one or two muscles, confirms Marvel J. Hammer, RN, CPC, CCS-P, PCS, ACS-PM, CHCO, of MJH Consulting in Denver. When the physician injects three or more muscles, opt for 20553 (... single or multiple trigger point[s], 3 or more muscle[s]). Remember, "coding is based on the number of muscles injected, not the number of trigger points in those muscles or the number of injections into those muscles," Hammer relays. Do Check for Acceptable ICD-9s Patients suffering from muscle pain receive TPIs for relief; [...]